Provider Demographics
NPI:1538392006
Name:COLLINGWOOD, LINDE (CNP)
Entity type:Individual
Prefix:
First Name:LINDE
Middle Name:
Last Name:COLLINGWOOD
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3304
Mailing Address - Country:US
Mailing Address - Phone:814-208-8430
Mailing Address - Fax:
Practice Address - Street 1:1122 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3304
Practice Address - Country:US
Practice Address - Phone:814-208-8430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015297363LA2200X
OHCOA-10920363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3013483Medicaid
OHRENP32061Medicare PIN